Mineral and Bone Disorders during Chronic Kidney Disease

Background: The objectives of our work were to describe mineral and bone disorders in patients with chronic kidney disease not yet at the dialysis stage and to assess the compliance of phosphocalcium balance indicators according to international KDIGO recommendations.
Methods: This was a cross-sectional, descriptive and analytical study conducted over a 10-month period in CHU la Renaissance in N’Djamena. We included all patients followed in the service for non-dialyzed CKD, aged over 18 years.
Results: 387 patient files were collated, 82 of which were retained. The mean age was 52.7 years (± 15.8), with a male predominance (67.1%). Comorbidities were arterial hypertension (71.9%) and diabetes (24.4%). Clinical signs were diffuse bone pain (37.8%), pruritus (8.5%), muscle pain (7.3%) and insomnia (8.5%). CKD predominated in stage V (55%), followed by stage III (23%). Hypocalcemia and hyperphosphatemia were noted in stage IV (11.9% and 10.7%) and stage V (40.5% and 34.5%). Hyperparathyroidism and 25 OH vitamin D deficiency were 28.8% and 40.5%. Compared with international KDIGO recommendations, compliance was 59.7%, 53.7% and 37% respectively for calcium, phosphorus and parathyroid hormone levels. Radiologically, pathological fracture features were observed in 4.9%. Management was based on calcium carbonate (52.4%), native vitamin D (64.6%) and Cinacalcet (6.1%).
Conclusion: The balance of mineral and bone disorders is far from being achieved for the majority of patients, due to lack of resources and the exorbitant cost of treatment. Prevention of BMD is a fundamental pillar of CKD treatment for our patients.

Keywords: Mineral and Bone Disorders, CKD, CHU- la Renaissance, Chad.